Lincoln University’s requirement that all obese undergraduates lose weight  or take a one-semester fitness and nutrition course to graduate has angered students, drawn questions from faculty and roiled many observers -- to the point that the institution may back down from the plan following a faculty forum later this week.
While Lincoln’s policy is extreme in mandating a class for students with a body mass index of 30 or greater, many other colleges and universities have developed less controversial programs aimed at fighting obesity among an ever-growing proportion of significantly overweight students. A 2007 analysis  of data collected for the Harvard School of Public Health’s College Alcohol Study found the proportion of obese college students increasing -- from 5 percent in 1993 to 8.4 percent by 1999. The spring  and fall 2008  National College Health Assessment surveys found 10 percent of college students to be obese.
Though other institutions aren't following Lincoln's lead in mandating a certain course, meal plan or exercise schedule just for obese or overweight students, they are offering coordinated weight loss programs, sessions with nutritionists, cooking classes, healthier dining options and more, all with the implicit goal of whittling down students’ waistlines.
“Obesity is absolutely a big problem in this country,” says Kathleen Malara, director of student health services at Fordham University. “Every college should have some way to promote healthy eating and exercise to students.”
Jennifer Haubenreiser, director of student health promotion at Montana State University and vice president of the American College Health Association, says that “college students, overall, tend to be a healthy population” less affected by obesity than is the general public. The National College Health Assessment data collected by the association suggest that one in 10 college students is obese, while a third of Americans over age 20 were classified as obese in the Centers for Disease Control’s 2006-07 survey .
Colleges, though, should still promote diet and exercise initiatives aimed at helping students develop healthy routines, adds Haubenreiser. “Obesity may not be an acute health concern on campus, but preventing this can certainly provide lifelong benefits for the individual as well as the national health care system.”
Striking a Chord
Lincoln University's aggressive approach has garnered an enormous amount of attention in recent days, and faculty leaders there are said to be reconsidering it. But the underlying issue that prompted the Pennsylvania historically black institution to act is generating significant concern on other campuses, too.
Colleges are seeing growing numbers of “students coming to campus, already with high blood pressure, high cholesterol, diabetes,” says Cynthia Burwell, a professor of health, physical education and exercise science at Norfolk State University. “They’re struggling with these issues and we need to help our students make better choices so they can be healthier.”
Her campus’s food court and student center include several fast food vendors which, she says, are students’ favorite places to eat. “Chick-fil-A and Pizza Hut are the most popular. Students love to go to those places and we do have a hard time trying to get students to break out of those habits since we’re offering the food right here on campus.”
There’s no effort to get rid of unhealthy options, she says, because “it’s clear they’re what students want, and we have to go with that.”
Karen Cutler, communications director for food services provider Aramark, says foods like french fries and pizza “are clearly the most popular” offerings and would never be eliminated from the company’s menus. “Like a lot of things in life, it’s about how to, in moderation, still enjoy the foods that you want to have as part of your social campus experience but knowing how to balance it out.”
At the University of South Carolina's main campus in Columbia, a string of efforts aimed at “making healthy choices simple” have been brought under the umbrella of the Healthy Carolina initiative. Michelle Burcin, director of the program, points to a four-season farmers' market that averages about $7,000 a week in sales, eight walking and running paths around campus, and Fitness Buddies , an anonymous online networking tool to match students, faculty and staff who share the same exercise interests.
The right sides of all campus vending machines are stocked with healthier snacks like high-fiber granola bars, baked chips and pretzels. “We’re not saying the only options are fruit or typical potato chips,” she says. “We’re showing them there’s something in between.”
The introductory University 101 class for freshmen includes talks on nutrition and health. The university’s Campus Wellness unit offers free nutrition consultations to all students, as well as Choose to Lose, an eight-week weight management program that includes exercise sessions, nutrition instruction and food logs.
Stacey Zawacki, director of Boston University’s Nutrition and Fitness Center, has in last few years developed the Sargent Choice program , which has worked to introduce “healthy food choices all across the campus environment,” she says. “If you’re in the mood for pizza, you should he able to have a healthy option on whole wheat dough. The same should go for any other kind of food. Healthy is sometimes perceived as not as satisfying or as appetizing but it can be just as good.”
Though some colleges – like Babson College, where 10 ounce ice cream servings have been cut in half  -- are turning to “the stealth approach, changing ingredients, making plates smaller,” Zawacki says this isn’t how she intends to get students to eat healthier. “We’re at a university and it’s our mission to educate people. We want people to understand and have full knowledge about what their choices are and then to make whatever choices they want based on that information.”
Gustavus Adolphus College, in St. Peter, Minn., has eliminated all-you-can-eat meal plans and instead requires students to pay for each item they take, à la carte. Food waste has been cut by 80 percent. Campuses that have made their dining halls trayless  also report dramatic reductions in food waste.
While it’s unclear whether these changes are actually leading students to consume fewer calories, Aramark’s Cutler says they “have certainly helped students think twice about what they’re choosing and maybe taking less -- and eating less -- than they would have before.”
Eating less, of course, has its dangers.
As colleges develop programs for overweight and obese students, it’s this challenge that comes up again and again: making sure the programs help those who need help, while not encouraging anorexia, bulimia and other forms of unhealthy weight loss.
“Colleges walk a fine line because of the prevalence of eating disorders,” says Fordham’s Malara. “Help obese students lose weight but don’t do anything that promotes eating disorders.”
Haubenreiser, the ACHA's vice president, warns that because "college students are ... at higher risk of body image issues and eating disorders... interventions and programming need to take" into account the unintended consequences of any offerings.
Deborah Zippel, South Carolina’s campus dietician, says the university tries to ensure that it’s not stoking the flames of eating disorders while trying to help the obese and overweight get healthier. “If a student’s not considered overweight, then they can’t be in the group,” she says, referring to the university’s Choose to Lose program. “We pay close attention to whether it seems like anyone in the class -- or really in any of our dealings having to do with nutrition -- needs additional counseling.”
Boston University’s Zawacki says efforts toward healthy eating and exercise are “very careful not to say ‘never have this, don’t do that.’ ” Instead, she tries to “help people feel confident about what they’re doing and what they’re eating.”
Another challenge colleges face in fighting obesity is a cultural and racial one.
Like Lincoln, Norfolk State is a historically black university. The 2007 study of Harvard’s data found that 19.2 percent of African American college students were obese in 1999, compared with 10.5 percent of Hispanic students, 7.9 percent of whites and 2.9 percent of Asians.
“Because we’re an HBCU, obesity is an issue we just can’t avoid,” Burwell says. “It affects African Americans disproportionately and we need to give students knowledge to prepare them for the real world, the working world.”
The Healthy Spartan Fitness Initiative aims to “change the culture on campus with regards to fast food, exercise and other issues related to obesity,” Burwell says. Campus dining halls are offering more salad options and more low-fat items and labeling them. A Facebook page encourages students to share strategies for healthy living . One recent discussion topic is "Pretty Hair and Working Out," directed at the large number of African American women who get hair weaves or braids that can't be washed.
Though an effort like Lincoln’s is not in the offing, Norfolk State does require freshmen to take a physical education course and a health education course. But the focus, Burwell says, is “not only about obesity and nutrition but other health information as well,” and enrollment is required of all students, not just those who fit a certain health profile.
“We acknowledge that before students get out in the real world, we can impact them by giving them factual information on the health problems -- like obesity -- that plague our community,” she adds. “We just know that every single one of our students needs this information.”